East Africa Aid Foundation

Our mission is to provide an opportunity, a helping hand, for those who have little-to-none to live by and learn with. We are a not-for-profit organization founded to assist with the collection of charitable donations from interested parties, multinational corporations, and healthcare organizations to fund educational & healthcare projects in multiple locations in the East Africa region.
Jul 28, 2014

UKUN Volunteer Diary (Week 24)

 The past two weeks at home-based care in Bagamoyo were busy with new and old patients. Bjarne; a Swedish student nurse joined our team for couple of weeks, which was great help for us. Kirstine our Danish volunteer said her goodbyes to us last week. She was a great asset to us and will be missed. Unfortunately sad news was delivered to us in the first week; our long term patient Mariam had passed away. We also discovered that Hadija was suffering from Malaria as well as Abdallah. People say that this is the worst season for Malaria as it rains often and mosquitoes love it. Patient ZZ, a new patient of us was admitted to the hospital and spent a week there to recover. We also received a new referral from CTC, a newly diagnosed HIV but already a very sick patient; RSM.

Update on patients:

Patient JJ:

Juliana is our fairly new patient (one month now) who is suffering from high BP (blood pressure) and reduced mobility. We have been monitoring her blood pressure every few days since she was started on BP medication couple of weeks ago. It all started well but then her BP was raised again last week. We added another BP medication that we had omitted the week before. We will have to wait and see if this will work and keep monitoring her. We cannot start physiotherapy until her BP is stable. She lives in a very basic house, sleeps on a stone floor with a very thin mattress. The room is too hot but she is not mobile to go out and she is a quite a large lady to transfer. It makes as really sad that all her family had abandoned her. However she is very lucky to have Oliva, a local mama who feeds and washes her every day.  

Patient AH:

Our 18 year old orphan boy AH called me on Sunday morning and told me he was sick. First I thought maybe he was hungry as Charles had gone away from the office for few days. I found him at the office with a fever and a headache. I took him to the local clinic in town (instead of queuing all day at the hospital lab) to rule out Malaria first but unfortunately it came back positive. He was only suffering from Malaria two weeks earlier. He got medications again and I took him back to the office, collected his lunch and advised to drink lots of water. He told me he has been sleeping at the office now for a while because his family circumstances were bad (again). Unfortunately a big stigma exists in his auntie’s house where he is supposed stay since his parents and grandmother died. He got HIV in birth from his mother and has suffered twice from TB (Tuberculosis) too. He has been very unlucky. There is no protection from mosquitoes in the office and I gave him my mosquito repellent cream. Very soon (January) he will start his school in Mbezi (Dar Es Salaam) and hopefully this can be a new hope for him for a better life. We will need to find him a clinic near to the school where he can pick up his HIV medication monthly and he needs to take responsibility for it.

Patient MP:

Patient MP our long term palliative care patient who had been in the last stage of AIDS for years now passed away at her home. It had been expected for a while now. She had almost no quality of life left since she had a stroke five years ago and her husband had died two years ago too. We hope she is in peace now. I and Bjarne attended to her funeral. There were a lot of people sitting on ‘mkekas’ (big floor rugs made of basket) and food as a typical funeral here. Most funerals last three days here in Bagamoyo. All the men had gone to bury the body. Her daughters were very sad and mourning. We showed our respects and left. It will be strange not having Mariam around anymore as I had cared for her almost a one year.

Patient CP:

Bjarne and I took patient CP to his monthly appointment to hospital CTC (Care and Treatment Clinic). Patient CP is wheelchair dependent and needs transport every month. He received good news as his CD4 count had gone up by one hundred to 461 in six months! We were all really happy. He has grown physically stronger in a year and is in much better spirits too. We continue to bring him extra snacks and clean drinking water. Big stigma exists in his family and living surroundings and he gets no help at all. None of the family members wants to co-operate with us either. We do the best we can to maintain some quality to his life. We continue to give him two weekly showers, laundry and clean his room. He is such a character and loves volunteers visiting but the same time all volunteers get fond of him too.

Patient ZZ:

Patient ZZ our HIV positive very frail lady has had a bad chest for a while and we were suspecting TB of course. Hospital had lost her sputum results so I took two new samples from her to the hospital. After two days I picked up the results and they came back negative. I was very surprised. The lab told me she can still have TB as it doesn’t necessarily show for HIV patients or if she has extra pulmonary TB. We took her to the hospital with Bjarne last Tuesday. By this time she was very weak and kept couching and producing sputum. Zena’s mother stayed home with her three children.

Patient ZZ had an X-ray done first that Mr. Charles had booked for her the day before. After this we went to see doctors-all 3 of them! They told us she did not have TB, it was PCP (Pneumocystis Pneumonia), which is common pneumonia for people with weak immune system like HIV patients. Patient ZZ's PCP was severe. She was admitted to the female medical ward. We were told the treatment should be IV Septrin but it was very expensive and not even available here so she would have to take it orally 9 tablets a day. She was also given fluids with glucose and strong antibiotics injections for 5 days, which were not available and we had to purchase them from the pharmacy in town. She had oral thrush too and found it hard to eat. She was prescribed oral gel Miconazole for that, which we purchased from the pharmacy in town again. We visited her for three daysand also brought food to her home for her three children. On Sunday, when we went to visit her again she had already been discharged home.

We will visit her at home next week and hope she is better. Doctors told us she has few years’ history of not being compliant with HIV treatment and doctors are reluctant to give her again. She has not always attended her appointments and has no family support. Her mother refuses to come to see the doctors together with Zena. Also because of this doctors won’t give her the treatment for HIV. Her next appointment will be at New Years Eve. I have asked our boss Mr. Charles to go with her for support and counselling. She needs to start treatment if she wants to live and take care of her three children, which one of them 8 year old Dotto is unfortunately also HIV positive. Dotto has his appointment on the same day with patient ZZ.

 New enrolled patient:

Patient RSM:

Last Tuesday a lady came to our office and asked for me. She had been told in CTC to find me for her sick brother. We went for a home visit together with Bjarne to assess the patient.

Patient RSM is 38 year old man who was diagnosed with HIV last July when he started to feel sick. He refused to accept these result and went to see a witch doctor. Months later he got really sick and with the encouragement of his family he was enrolled to CTC to seek treatment. This was early November this year (last month). He was started on Septrin (antibiotic) only. Then a week later his CD4 was checked and he waited a week for the results. The CD4 was only 144. By this time he was very sick. His Haemoglobin (Hb) was very low 6.9, and to start HIV treatment it must be 8 or above. Doctors sent him home and gave him medicines to boost his Hb (Hemovit), Paracetamol, B vitamin and multivitamins and told him to come back a week later.

We arrived at his house the day after he had been to the hospital. We found this tall man who looked very malnourished. His family was there; 2 brothers and a one sister who all seemed really friendly and caring for their brother. Ramadhani the patient told us he has been eating. He told us he was still walking but only short distances. He was breathless. We checked his physiological observations; BP 90/70, heart rate 110bpm, respiration rate 30 and temperature 37,5 degrees. He had no cough and there were no crackles when listening to his chest. He reported no diarrhoea or any other problems with elimination. We advised him and his family to relieve his pressure areas with changing position and using pillows. We gave advice on iron rich diet to boost his Hb quicker and told him to drink plenty. His next appointment will be next Monday 23dr of December and we will go with him to the hospital. We hope his Hb will be increased so he can start on HIV medication.  

Patient HD:

Our blind HIV patient HD got sick with flu and tested positive for Malaria. She received treatment and we visited her at home with volunteers Kirstine and Bjarne. After couple of days she was already better and back to her cheerful self.

It was Kirstine’s last week and she took us for a nice meal including Abdallah. Kirstine taught me how to update the patient CD4 graphs that she had created. We are so grateful for all the hard work she has put in and will miss her a lot!

Next week is Christmas and we have great plans to bring some Christmas spirits to our patient in Bagamoyo. My father did a Christmas collection from his friends to our patients and the total came over 300 euros! Christmas is surely the time for giving.

Jul 14, 2014

UKUN Volunteer Diary (Week 23)

The past two weeks in Bagamoyo I continued working with volunteer Kirstine. I got flu for few days but luckily it was not serious illness. We had a great success at World HIV Day and continued home-based care with our old and some new patients.

Kirstine created patient record system with Excel program to record all the people who come for testing at the office. She also collected all history of CD4 counts from our home-based care patients and we weighed most patients with new scales we purchased (some of the immobile patients we were not able to weigh). From the information she created a graph so we can see and monitor the progress of our patients. This is something that was planned long time ago but it was Kirstine finally who followed it through and she made a great success.

World HIV Day 1st of December was a great success too. Godfrey came from Dar to help us and together with Charles set up a spot to the middle of the bus station and test people for HIV. Chanzi also gave a hand with setting up posters and we had lots of stickers and red ribbons that were donated from UK based HIV Charity through Debbie; our faithful sponsor and volunteer from the UK. 54 people, young and old were tested on that day! One older man tested positive and was referred to CTC at the hospital for a follow up and more counselling. He had a strange reaction to his results; he was happy and said ‘It is OK because now there is good treatment for it.

Couple of weeks ago Kirstine organized to have testing for pre- school children at our UKUN/PHI office. Two groups of 10 came in two different days. No one was found positive. This was a great idea and something we should expand to the other schools at Bagamoyo too.

Update of patients:

Patient G from Morogoro family:

We have been visiting patient G weekly and every time we see him he looks healthier and he is getting stronger. He had his hospital appointment for refill of ARV medication. He still reports dizziness and doctors told him he has a low blood pressure. We have been checking it ever since and it is within normal range. Otherwise he has no other problems. He has gained even more weight and his mobility is almost back to normal. I gave him multivitamins for a month and we give him porridge and fruit every week. He is missing his family greatly but soon he will be fully recovered and go back home to his wife and baby boy Michael. Hospital still has not received results for HIV test from the little boy Michael. This sample was taken about two months ago now and sent to Muhimbili Dar Es Salaam. I wonder if we will ever get them. I will attend his next hospital appointment with him on New Year ’s Eve.

Patient Z and her daughter Hadija we visited both weeks but found that they were not home. Apparently Hadija works now near the beach every day and her mother Patient Z had gone to the farm. Last time we saw them was a month ago and luckily Patient Z had recovered from her stomach ulcers and had got back her mobility. We are not concerned and they have our number if they need us.

Patient A & Patient H - Tanga family

We visited Amina and her brother H to talk and help about plan for future and getting out of poverty. Their health is stable now and patient A continues her physiotherapy with exercises and walks with her frame. Hamisi has fully recovered from his operation and we helped to restart his cigarette business few weeks ago. Now he reports that is going OK. Patient A had been keen for a long time to sell something too outside her house and we supported her with bagging and selling bags of charcoal. A big bag of charcoal to start the business with cost £12. If this business works out well for her we will increase the business and add firewood too to sell. Due to her mobility she can only sit down (and walk short distances with a frame) so selling things outside works well for her. They are both very grateful of our support and we will review them next week.

 

Patient MP:

Patient MP, our palliative care patient was supposed to have her monthly hospital appointment on the 6th of December but family did not want to take her that day. This has been continuous problem the whole year. We visited them with Kirstine later that afternoon to assess her condition only to find her in a very ill health. Patient MP appeared to have had lost weight again after last hospital admission (she had Meningitis), which was last month. Family reported that she is only eating very small amounts and not taking medication. In my opinion she looked like she did not have many days left in this world. Family said they did not want to take her to the hospital again for feeding with nasogastric tube. I understood their decision and said it was up to them. She has been on this stage of ‘suffering’ for many years now (stage 4 AIDS). Her eyes looked almost black and had no ‘life’ in them. She was not responding to voice or pain. I held her hand and wished that she would feel no suffering. She did not look agitated or uncomfortable. Family had already spoken to Patient MP's sister Mama Kizenga and she had told them that patient MP has suffered for too long. Her daughter asked me why is she like this and if she will die now. I told them I think patient MP is tired of life. I told them to call me if they get any worries. We went back few days later and MP looked a little better again. She did not look like she was in any pain or was uncomfortable. She had little temperature so we gave her liquid Paracetamol, which she swallowed. That day her daughter told me that she had had porridge and juice. We will visit every few days to assess her comfortability. I feel really sad as I have grown very close to her this year but I know that she has almost no quality of life. The smiles have now gone.

 

Patient ZM Ramadhani and her children:

This frail 29 year old lady called Zena came to our office few weeks ago with her three children. Patient ZM and Ramadhani Dotto her eldest son of 8 years are HIV positive. They had not been taken medications ARVs because of lack of support and nutrition. Now the hospital gave them to restart again. The family fled from their home a week ago due to stigma. Now they stay in another small house with two rooms.

We went for a home visit last Friday to assess their needs. Patient ZM is very malnourished, 35kg only. She has been coughing blood, has diarrhoea, stomach pain and has ulcers in her mouth. She was dehydrated, her blood pressure was low 90/70, heart rate 120bpm and temperature 38 degrees. She was also breathless. Two weeks ago she went to Bagamoyo Hospital for a TB sputum test and they gave her medicines for her mouth. Now she went to get her result but they could not find them. We gave her Paracetamol and promised to go to the hospital to find her results. Her last CD4 count was done one year ago and it was high 1291. Ten months before that it was only 195. It must be very low now too. She really needs a new one done. Her son’s last CD4 count was done one year ago too and it was 1282. They have both attended their monthly hospital appointments regularly but why has the CD4 not been checked. This is a big failure from the hospital. They both have their next clinic appointment at New Year’s Eve 31/12/2013 and I will make sure to go with them to get it done.

One of the children at their house was lying on the floor holding his stomach and saying he was hungry. All the children appeared small but not as malnourished as their mother Zena. We gave them 1kg of porridge and sugar and told the little boy to get up and start cooking it. He started to make a fire inside the room with firewood and washed a pan for cooking. They do not have a local cooker even. One of the children asked for a bicycle. They have no food but of course those things can seem more important to a child. They have no money or income. They were waiting for Zena’s mother to return in the evening to bring food and cook for them. On Sunday I went back with Chanzi and took lots of foods for them; bananas, rice, potatoes, vegetables and drinking water. First thing we need to do on Monday is to find her TB results so she can start a treatment if it comes back positive.

 

New Patient JJ:

We got our first referral from CTC with our referral forms we created. This was Patient JJ, 56 year old lady who is HIV positive. She was referred to us for physiotherapy and transport to hospital. Charles from our office said he knows her and this lady apparently cries a lot.

I went for a home visit with Kirstine last Friday morning. A local lady who is taking care of her took us there. Shew told us that JJ's family had abandoned her so she was alone otherwise. We found her lying on the floor and she started to cry when we came. She was not able to walk and had lost her mobility about one year ago. She was able to speak a little through her tears and said her legs were painful. She seemed anxious too.

We checked her physiological observations and her blood pressure was high 170/120. I checked her other arm and it was even higher 170/130. Her pulse was 120bpm and respiration 28bpm. She had no temperature. She had been to the hospital last September (2.5 months ago) but they had not checked her blood pressure. She was not on ARV medication; in fact the only medication she had was Vitamin B tablets. Her CD4 count was done September too and was 451. We decided to take her to the hospital to see a doctor for her blood pressure. We had to carry her into the bajaji (three wheeled small car) and she was not light! Once we arrived at the hospital and got through to the doctor he did not seem happy because it was not her ‘appointment date’. I explained about her blood pressure and he asked me to check again there at the hospital. It was still high. Doctor asked questions about her history and started to be helpful. She was started on two different blood pressure tablets, Diazepam for anxiety and Diclofenac for pain. Doctor told me to go to check her blood pressure the next day. We took her home and explained about her medications. I went back next day and her blood pressure had dropped to 140/80.

She appeared tired but that was possibly due to having been started on Diazepam the night before. I omitted one of the blood pressure medications as the doctor had advised and she continued with the other. We will monitor her every few days at first. When her blood pressure becomes stable we can assess her mobility and possibly start physiotherapy.

 

Next week we will be busy with new patients and luckily we have a new volunteer Bjarne to join us. He is a student nurse from Sweden and will be with us for ten days. Kirstine has another two weeks left with us. It will be my first Christmas here in Tanzania in two weeks time and I am looking forward to it!

Jun 30, 2014

UKUN Volunteer Diary (Week 22)

 The past two weeks at Bagamoyo we had a great team of 4 volunteers. I was away the first week in Zanzibar but Debbie, Godfrey, Kirstine and Charles took good care of the patients. We continued home-based care, did regular visits to Mariam at the hospital, did testing at the office and put out posters to promote our office HIV testing. Unfortunately we were sad to see Debbie and Godfrey to go last week as they were such a great asset to us but they have both promised to come back soon. We were fortunate though to receive help and medical supplies from Kirstine’s boyfriend who is visiting here. He is a doctor specialized in surgery and will give us plenty of teachings on medical assessments!

 

Patient MP:

MP was put on a drip at home for couple of days but we knew it was not enough as she was not swallowing any medicines at all. Her diarrhoea continued. We obtained a blood sample from MP and took it to the clinic to check malaria and it came back negative. Finally the next day Mariam’s family agreed to take her to the hospital for feeding. I was relieved as I was going on a trip to Zanzibar the next day. She was put on Sodium Lactate drip (that was almost impossible to get from Bagamoyo, luckily found one in our office!) and they discovered that she had meningitis. They treated her with IV Fluconazole for few days. She had nasogastric tube inserted and was fed porridge and medicines through it as she was unable to swallow for several days. After a week she was better and discharged home. Mariam appears just the same as she was before this illness. Peter Kirstine’s boyfriend assessed her on a home visit and also said there is not much we can do for her, only palliative care to keep her comfortable. We put on some new medicine dressing to her pressure sore and it appears to be healing. Debbie’s gift Sudacrem is also a great help for her. She appeared comfortable but we will get some small cushions to put between her limbs for pressure care. Mariam is able to swallow again but is eating only small amounts of porridge. She is refusing to drink ORS (oral rehydration salts). Family were grateful for all our support; we gave them more gloves, disinfectant and juice for Mariam.

 

Patient AB:

Unfortunately AB got sick at the office for couple of days. We all assumed that it was due to him missing out three day of his ARV medications! We told him off for not being compliant with ARVs and the consequences that can follow. We told him he is throwing away his opportunity to start the art school in January if he will not be well enough.

The second day evening we took him to the hospital to see a doctor and after some blood tests they discovered malaria. He was given medications for three days. He appears already better from it. He needs repeat medications for malaria this week and then next week to retest. Peter brought him a present from Denmark; a pillbox with weekdays written on it! We can keep proper check on his medications and it will be hard for him to miss again. He has understood how it works and is all motivated again to get himself healthy for GOIG School for January 2014 J

 

Patient CPT:

CPT continues to get our support for two showers a week, laundry, cleaning and exercise. Debbie and Kirstine took him for a walk on his wheelchair whilst I was in Zanzibar and he really enjoyed that! He received a new ‘mohican’ haircut and a shave from Godfrey and a new bucket that is easier to empty for his toilet chair. Peter assessed his mobility a little last week and told us to continue with the chair exercises. The exercise pole he said would be so great for him but after the family took the last one down we are hesitating to waste our time to build another one. Peter is not the first doctor to tell CPT that with some exercise and building more muscle to his thighs he could walk again. Peter also discovered that CPT has scrotal hernia, which Captain was aware of already but as he experiences no pain it should not be dangerous. CPT was showing of his big arm muscles as usual and his ‘pot’ belly but Peter told him his swollen stomach was not fat, just ‘air’ but his arm muscles are real at least.

  

New family :

A family that was known to UKUN/PHI office a long time ago came by the office last week. It was a mother with her three children. Her husband had died. Mother is HIV positive and her eldest son of eight years of age. Both of them are not taking medications (ARVs) due to lack of support and nutrition. The other two younger children fortunately tested negative. Mother appeared severely malnourished and weighed only 37kg. Debbie and Charles gave them some food at the office and we bought 1kg of porridge if they come back next day. The mother went to the hospital twice in two days but we never saw her again at the end of the second day. Therefore we do not know what the doctors had told her and if she was given any medications. We need to go for a home visit this week to assess their housing situation and assess all the family members’ needs for support.

We had a lovely ‘Thank you & see you later’ meal for Debbie and Godfrey at Poa Poa restaurant here at Bagamoyo. Both of them will be back soon to volunteer with us.

We have been doing a shoe and necklace campaign with two local artists; Chanzi and Zakaria to raise funds for our patients. Debbie has taken the order to Europe; 20 pairs of shoes and 11 necklaces. With this we managed raise over £100! We also received another £60 for Kathy’s cake sales from Plymouth! Great stuff!

This week there are no volunteers working with me but luckily none of our clients are critically ill this moment. Kirstine and Peter are coming back from their trip from Zanzibar at the weekend. Sunday this week, 1st December will be the ‘World HIV Day’. We are still finding out where it will be happening in Bagamoyo but certainly we will be joining in with testing, information, free condoms and red ribbons!

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